Colonização Retal por Bacilos Gram-Negativos Resistentes aos Carbapenêmicos: Estudo de Vigilância em Unidade de Terapia Intensiva

Abstract

Antimicrobial resistance is one of the greatest threats to global public health, especially in intensive care units (ICUs), where the high complexity of care favors the dissemination of multidrug-resistant microorganisms. This study aimed to evaluate the prevalence of rectal colonization by carbapenem-resistant Gram-negative bacilli (CR-GNB) in patients admitted to the ICU of a teaching hospital between 2021 and 2024. This was a cross-sectional and retrospective study based on the analysis of surveillance culture results and clinical and demographic data obtained from electronic medical records. A total of 290 rectal swabs were analyzed, of which 53.1% were from male patients and 46.9% from female patients, and 92 (31.72%) showed growth of CR-GNB. Among the identified microorganisms, 55.3% were carbapenem-resistant Enterobacterales, 36.8% belonged to the A. baumannii complex, and 7.9% were P. aeruginosa. Within the isolated Enterobacterales, K. pneumoniae was predominant (71.4%), followed by Enterobacter cloacae (7.9%), Escherichia coli (7.9%), Klebsiella sp. (4.8%), Proteus sp. (3.2%), Serratia sp. (3.2%), and Pantoea sp. (1.6%). Colonization was more frequent in male patients, whose mean age was 61.7 years. The high prevalence of CR-GNB highlights the importance of continuous epidemiological surveillance programs in ICUs, reinforcing the need for effective prevention and infection control strategies.